MedicaidPrior AuthHigh impact
Changes to the CT Medicaid Preferred Drug List 07.01.2022
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List (PDL) effective July 1, 2022, with changes to preferred and non-preferred medications. Prior authorization is required for non-preferred drugs, but pharmacies can dispense a one-time 14-day supply using override codes, and providers can use the Web PA tool for authorization requests.
Action Required
Immediately: Billing team must update pharmacy billing systems to recognize new Connecticut Medicaid PDL changes. Configure systems to require prior authorization for non-preferred medications. Train staff on 14-day override billing using NCPDP field 462-EV (all 9's) and field 461-EU (value '1'). Update DAW code usage: use '5' or '9' for preferred brand medications instead of '1' unless medically necessary documentation exists. Ensure proper documentation for DAW '1' claims to avoid recoupment during audits.